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European Archives of Oto-Rhino-Laryngology

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01-10-2016 | Head and Neck

Risk of reoperation after tonsillotomy versus tonsillectomy: a population-based cohort study

Authors: Erik Odhagen, Ola Sunnergren, Claes Hemlin, Anne-Charlotte Hessén Söderman, Elisabeth Ericsson, Joacim Stalfors

Published in: European Archives of Oto-Rhino-Laryngology | Issue 10/2016

Abstract

Tonsil surgery to address upper airway obstruction in children can be performed either as a tonsillectomy (TE) or as a tonsillotomy/intracapsular/partial tonsillectomy (TT). The advantage of TT is a decreased risk of postoperative morbidity. The disadvantage is the risk of tonsil regrowth with recurrence of symptoms and/or problems with future tonsil infections, which may demand a reoperation of the tonsils. The aim of this study is to compare the risk of reoperation of the tonsils following TE and TT in children with tonsil-related upper airway obstruction. This is a retrospective register-based cohort study of the Swedish National Patient Register. All children aged 1–12 years who underwent TE or TT from 2007 to 2012 for the main indication of upper airway obstruction were included in the study. The unique Personal Identity numbers were used to follow patients over time in the register and identify additional tonsil surgery. A total of 27,535 patients were included in the study, contributing 76,054 person-years of follow-up. A total of 684 patients (2.5 %) underwent a second tonsil surgery during follow-up. The incidences of reoperation were 1.94 per 1000 person-years in the TE group and 16.34 per 1000 person-years in the TT group. The risk for reoperation was seven times higher (HR 7.16) after TT compared to TE. Younger age was significantly associated with reoperation for both TE and TT and the difference in risk between TE and TT gradually decreased with time. The most common indication for reoperation after both TE and TT was “Upper airway obstruction”.

Goldman JL, Baugh RF, Davies L, Skinner ML, Stachler RJ, Brereton J, Eisenberg LD, Roberson DW, Brenner MJ (2013) Mortality and major morbidity after tonsillectomy: etiologic factors and strategies for prevention. Laryngoscope 123(10):2544–2553. doi:10.1002/lary.23926 PubMed

Stalfors J, Ericsson E, Hemlin C, Hessén Söderman A-C, Odhagen E, Sunnergren O (2014) Annual report 2013 of The National Tonsil Surgery Register in Sweden. Karolinska University Hospital, Stockholm, Sweden. doi:10.13140/2.1.1680.1605

Parker NP, Walner DL (2011) Trends in the indications for pediatric tonsillectomy or adenotonsillectomy. Int J Pediatr Otorhinolaryngol 75(2):282–285. doi:10.1016/j.ijporl.2010.11.019 CrossRefPubMed

Walton J, Ebner Y, Stewart MG, April MM (2012) Systematic review of randomized controlled trials comparing intracapsular tonsillectomy with total tonsillectomy in a pediatric population. Arch Otolaryngol-Head Neck Surg 138(3):243–249. doi:10.1001/archoto.2012.16 CrossRefPubMed

Acevedo JL, Shah RK, Brietzke SE (2012) Systematic review of complications of tonsillotomy versus tonsillectomy. Arch Otolaryngol-Head Neck Surg 146(6):871–879. doi:10.1177/0194599812439017 CrossRef

de la Chaux R, Klemens C, Patscheider M, Reichel O, Dreher A (2008) Tonsillotomy in the treatment of obstructive sleep apnea syndrome in children: polysomnographic results. Int J Pediatr Otorhinolaryngol 72(9):1411–1417. doi:10.1016/j.ijporl.2008.06.008 CrossRefPubMed

Hultcrantz E, Ericsson E, Hemlin C, Eggersten R, Lundeborg-Hammarstrom I, Marcusson A, Proczkowska-Björklund M, Stjernquist-Desatnik A, Zettergren-Wijk L, Moa G, Törnqvist H (2011) Swedish National medical indications—Indication for tonsillotomy in children. Available online in Swedish. https://www.socialstyrelsen.se/SiteCollectionDocuments/nationella-indikationer-tonsillotomi-barn-ungdomar.pdf. Accessed May 2015

Windfuhr JP, Savva K, Dahm JD, Werner JA (2015) Tonsillotomy: facts and fiction. Eur Arch Oto-rhino-Laryngol 272(4):949–969. doi:10.1007/s00405-014-3010-x CrossRef

Celenk F, Bayazit YA, Yilmaz M, Kemaloglu YK, Uygur K, Ceylan A, Korkuyu E (2008) Tonsillar regrowth following partial tonsillectomy with radiofrequency. Int J Pediatr Otorhinolaryngol 72(1):19–22. doi:10.1016/j.ijporl.2007.09.007 CrossRefPubMed

10.

Dearking AC, Lahr BD, Kuchena A, Orvidas LJ (2012) Factors associated with revision adenoidectomy. Otolaryngol-Head Neck Surg 146(6):984–990. doi:10.1177/0194599811435971 CrossRefPubMed

11.

Eviatar E, Kessler A, Shlamkovitch N, Vaiman M, Zilber D, Gavriel H (2009) Tonsillectomy vs. partial tonsillectomy for OSAS in children—10 years post-surgery follow-up. Int J Pediatr Otorhinolaryngol 73(5):637–640. doi:10.1016/j.ijporl.2008.12.012 CrossRefPubMed

12.

Mangiardi J, Graw-Panzer KD, Weedon J, Regis T, Lee H, Goldstein NA (2010) Polysomnography outcomes for partial intracapsular versus total tonsillectomy. Int J Pediatr Otorhinolaryngol 74(12):1361–1366. doi:10.1016/j.ijporl.2010.09.003 CrossRefPubMed

13.

Ericsson E, Graf J, Lundeborg-Hammarstrom I, Hultcrantz E (2014) Tonsillotomy versus tonsillectomy on young children: 2 year post surgery follow-up. J Otolaryngol-Head Neck Surg 43(1):26. doi:10.1186/s40463-014-0026-6 CrossRefPubMed

14.

Stalfors J, Ericsson E, Hemlin C, Hultcrantz E, Mansson I, Roos K, Hessen Soderman AC (2012) Tonsil surgery efficiently relieves symptoms: analysis of 54 696 patients in the National Tonsil Surgery Register in Sweden. Acta Otolaryngol 132(5):533–539. doi:10.3109/00016489.2011.644252 CrossRefPubMed

15.

Sarny S, Habermann W, Ossimitz G, Stammberger H (2013) What lessons can be learned from the Austrian events? ORL 75(3):175–181. doi:10.1159/000342319 CrossRefPubMed

16.

Wood JM, Harris PK, Woods CM, McLean SC, Esterman A, Carney AS (2011) Quality of life following surgery for sleep disordered breathing: subtotal reduction adenotonsillectomy versus adenotonsillectomy in Australian children. ANZ J Surg 81(5):340–344. doi:10.1111/j.1445-2197.2010.05604.x CrossRefPubMed

17.

Walner DL, Parker NP, Miller RP (2007) Past and present instrument use in pediatric adenotonsillectomy. Otolaryngol-Head Neck Surg 137(1):49–53. doi:10.1016/j.otohns.2007.02.036 CrossRefPubMed

Title: Risk of reoperation after tonsillotomy versus tonsillectomy: a population-based cohort study
Authors: Erik Odhagen
Ola Sunnergren
Claes Hemlin
Anne-Charlotte Hessén Söderman
Elisabeth Ericsson
Joacim Stalfors
Publication date: 01-10-2016
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 10/2016
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-015-3871-7

At a glance: The STEP trials

Springer Medicine

Risk of reoperation after tonsillotomy versus tonsillectomy: a population-based cohort study

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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